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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Classification of Chondral and Osteochondral Injuries of the Knee 

  - See:
      - Knee Joint Menu:
                - Arthroscopy of the Degenerative Knee
                - Osteochondritis Dessicans
                - Osteoarthritis

- Discussion:
    - described types articular cartilage lesions;
            - mild lesion, w/ normal appearing cartilage - it is difficult to dissern borders of lesion and normal surrounding cartilage.
            - mild fibrillation, discoloration, cartilage softer than normal;
            - linear crack: usually split thickness, and often encountered on lateral tibial plateau in assoc w/ anterior cruciate injuries;
            - stellate: most common;
                  - diverging w/ central flaking of the cartilage;
            - flap tear: the carilage is avulsed from the subchondral bone;
            - partial thickness w/ fibrillation;
            - crater: full thickness, in which subchondral bone is exposed;
            - degrading lesion: cartilage is degenerative in nature and extends down to subchondral bone;
    - Outerbridge classification:
            - grade 0: normal cartilage;
            - grade I: cartilage with softening and swelling;
            - grade II: a partial-thickness defect with fissures on the surface that do not reach subchondral bone or exceed 1.5 cm in diameter;
            - grade III: fissuring to the level of subchondral bone in an area with a diameter more than 1.5 cm;
            - grade IV, exposed subchondral bone.
    - Lysholm knee scale:
            - originally designed to assess ligament injuries of the knee but later has been used to asses chondral injuries of the knee;
            - outcome measure that contains 8 domains: limp, locking, pain, stair-climbing, support, instability, swelling, and squatting;
            - score of 0 to 100 is calculated:
                   - 95 to 100 indicates an excellent result;
                   - 84 to 94 indicates a good result;
                   - 65 to 83 indicates a fair result;
                   - less than 65 indicates a poor result



A system for grading articular cartilage lesions at arthroscopy

Reproducibility and Reliability of the Outerbridge Classification for Grading Chondral Lesions of the Knee Arthroscopically

Reliability, Validity, and Responsiveness of the Lysholm Knee Scale for Various Chondral Disorders of the Knee.

Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale.

Rating systems in the evaluation of knee ligament injuries.

Isolated chondral fractures of the knee

Mesenchymal Cell-Based Repair of Large Full Thickness Defects in Articluar Cartilage

Spontaneous repair of superficial defects in articular cartilage in a fetal lamb model.  

Autologous chondrocyte implantation compared with microfracture in the knee. A randomized trial.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, August 31, 2012 11:25 am